Heel spurs, also called calcaneal spurs or osteophytes, are calcium deposits that look like a bony protrusion on the lower side of the heel bone. They are usually detectable through X-rays as a half-inch extension. If undetectable, the condition is called heel spur syndrome. While spurs are painless, they can sometimes hurt as they cause inflammation in the plantar fascia tissue connecting the ball of the foot and the heel bone.
Causes and risk factors
Heel spurs are caused when calcium is deposited on the bottom of the heel bone. They occur gradually over weeks or months. The condition can also be triggered due to stretching of the plantar fascia, a strain on the foot muscles, or recurrent tearing of the membrane covering the heel bone. It is common among athletes engaging in regular jumping and running.
Some risk factors that increase one’s likelihood of developing heel spurs include:
- Diabetes
- An abnormal walking gait that stresses the ligaments, heel bone, or nerves near the heel
- Poor quality shoes that do not fit or lack proper arch support
- Decreased flexibility in the plantar fascia that comes with age
- Thinning of the protective pad in the heel
- Standing for prolonged periods
- Recurrent physical activity in short bursts
- High arches or flat feet
Signs and symptoms
Heel spurs usually do not have symptoms but can sometimes cause chronic or intermittent pain. The pain is mainly felt while running, jogging, or walking and if inflammation occurs. It is important to note that the pain is not because of the heel spur itself but the related soft tissue injury.
Patients have described the heel spur and plantar fasciitis pain as a sharp object stuck in the bottom of their feet while standing up in the morning. This then takes the form of a dull ache, which often returns as sharp pains while standing up after a lengthy period of sitting.
Other symptoms of heel spurs include:
- Inflammation
- A swelling in the front of the heel
- The affected area feels warm to the touch
- A small, bony protrusion and a tender spot at the heel bottom that makes walking without footwear difficult
Treatment options and remedies
Treatment is recommended when the spur persists for over a month and does not respond positively to rest. Doctors may recommend either surgical or non-surgical methods. The following non-surgical treatments and popular remedies aim to reduce inflammation and pain:
- Wearing comfortable shoes
- Using functional orthotic devices like shoe inserts
- Exercises involving stretching, strapping, or taping the affected muscles and tendons for them to rest
- Night splints
- Physical therapy
While non-surgical therapies are sufficient for the vast majority of patients (about 90%), there are instances where the symptoms do not respond satisfactorily to these treatments, even if they are followed thoroughly for nine to 12 months. In such cases, surgical remedies become necessary to restore mobility and relieve pain. Surgical treatment approaches aim to remove the spur or plantar fascia. The doctor may run tests before and after a procedure to ensure the desired outcome is achieved.
